Associate Professor Christine Howitt

Associate Professor Grace Oakley

Graduate School of Education
The University of Western Australia
M428, 35 Stirling Highway,
Crawley, WA, 6009
Telephone: +61 8 6488 3038
Fax: +61 8 6488 1052
Email: christine.howitt@uwa.edu.au or
grace.oakley@uwa.edu.au

Teacher Consent Form

CRICOS Code: 00126G

I have read the information provided and any questions I have asked have been answered to
my satisfaction. I agree to participate in this classroom-based research, realising that I may
withdraw my consent at any time before anything is published, without reason and without
prejudice. I understand that my participation is voluntary.
I understand that participation in the research project will involve me being interviewed about
the effectiveness of an intervention on a child or small group of children in my classroom.
These interviews may occur across the course of the intervention, may be audio-recorded,
and would take between 5 to 15 minutes.
I understand that the information collected from me will be kept confidential, will only be used
for the purposes of this project, and I will not be identified in any written assignment or
presentation of the results of this project. The only exception to this principle of
confidentiality is if documents are required by law. I have been advised as to what data is
being collected, what the purpose is, and what will be done with the data upon completion of
the research.

_______________________
Name of teacher

______________
Date

______________________
Signature

UWA Ethics Approval Number:

Approval to conduct this research has been provided by the University of Western Australia, in accordance with its ethics review
and approval procedures. Any person considering participation in this research project, or agreeing to participate, may raise any
questions or issues with the researchers at any time.
In addition, any person not satisfied with the response of researchers may raise ethics issues or concerns, and may make any
complaints about this research project by contacting the Human Research Ethics Office at the University of Western Australia on
(08) 6488 3703 or by emailing to hreo-research@uwa.edu.au
All research participants are entitles to retain a copy of any Participant Information For and/or Participant Consent Form relating
to this research project.